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1 : , 2018 Research and development of diagnostic imaging system for macular disease Masahiro MIURA Department of Ophthalmology, Tokyo Medical University, Ibaraki Medical Center scanning laser ophthalmoscope : SLOoptical coherence tomography : OCT OCT angiography 1998 Elsner SLO 2005 COG OCT : :

2 212 東京医科大学雑誌第 76 巻第 2 号 12 RPE SLO 1 SLO SLO SLO flood illumination 科 SLO SLO SLO Laser Diagnostic Technologies Carl Zeiss Meditec GDx GDx GDx GDx - N 大学 GDx - N 16 3 GDx - N 医 GDx - N 東京医科大学 医 科 SLO 1 4 uncrossed channelcrossed channel SLO a Henle Henle Henle Henle Haidinger s brushes Henle 1 SLO 2

3 三浦 : 黄斑疾患画像診断技術の開発 の SLO 画像 の SLO 画像 画像 画像 画像 bow tie SLO の 画像 の Henle のbow tie 2の SLO 黄斑疾患 の の の 4 のの Henle の 5 b 画像診断の 技術 発 画像診断 画像 の の RPE RPE の の 画像 の 画像 3 6 c RPE RPE の 画像の RPE の 3 黄斑 の SLO 画像 画像 画像 黄斑 画像 6 4 の 画像 SLO 画像 画像 画像 4 発 の RPE 画像 RPE 4 4 RPE 発 3

4 214 東京医科大学雑誌第 76 巻第 2 号 OCT 1 OCT OCT OCT 科 医 OCT OCT 7 OCT COG 大学 OCT 科 2006 OCT X Y 2 科 OCT OCT degree of polarizarion uniformity : DOPU 5 89 DOPU OCT a SLOGDx OCT 3 10 b OCT 11 c 12 d RPE RPE OCT RPE e Vogt OCT DOPU DOPU RPE 16 Vogt 科医 DOPU 4

5 三浦 : 黄斑疾患画像診断技術の開発 215 6Vogt - - の OCT 画像 画像 DOPU 画像 DOPU 画像 診断 6 の OCT Vogt - - の診断 の 黄斑 の 疾患 の OCT 画像診断 OCT SLO 3 の OCT SLO のの OCT の画像 SLO 画像 画像 画像の 画像 発 の 画像 画像 の 画像 黄斑 RPE 13 黄斑 RPE の RPE RPE の の 17 の OCT 画像 Hyper - reflective foci : HRF RPE 17 HRF の RPE の HRF のRPE の OCT の 3 SLO の 7 13 RPE の 画像 の RPE の 画像 画像 480 nm 画像 SW - AF 780 nm 画像 NIR - AF HRF HRF RPE OCT の 3 画像 HRF のの 画像の 3 黄斑 155 の 画像 のOCT の HRF DOPU の の SW - AF NIR - AF の 7 の OCT 画像 画像 DOPU 画像 minimum DOPU 画像 SLO 画像 画像 13 5

6 216 東京医科大学雑誌第 76 巻第 2 号 RPE SLO 7 OCT 3 HRF SW - AF NIR - AF RPE 8 RPE RPE SW - AF RPE RPE RPE 科 科 大 3 科 医 医 東京医科大学 医 科 2005 COG 大学 OCT 医 COG 大学 OCT HRF DOPU 480 nm 780 nm 13 9 A 大学 OCTB 東京医科大学 医 科 OCT 6

7 三浦 : 黄斑疾患画像診断技術の開発 217 OCT 1,100 の患 OCT OCT+OCT angiography+ OCT 9 画像診断 開発 の発 の ののの 15K COI 三浦 : 1 Baumann B, Baumann SO, Konegger T, Pircher M, Gotzinger E, Schlanitz F, Schutze C, Sattmann H, Litschauer M, Schmidt - Erfurth U, et al : Polarization sensitive optical coherence tomography of melanin provides intrinsic contrast based on depolarization. Biomed Opt Express 3 : , Lammer J, Bolz M, Baumann B, Pircher M, Gerendas B, Schlanitz F, Hitzenberger CK, Schmidt - Erfurth U : Detection and analysis of hard exudates by polarization - sensitive optical coherence tomography in patients with diabetic maculopathy.invest Ophthalmol Vis Sci 55 : , Elsner AE, Weber A, Cheney MC, VanNasdale DA, Miura M : Imaging polarimetry in patients with neovascular age - related macular degeneration.j Opt Soc Am A Opt Image Sci Vis 24 : , Miura M, Elsner AE, Weber A, Cheney MC, Osako M, Usui M, Iwasaki T : Imaging polarimetry in central serous chorioretinopathy.am J Ophthalmol 140 : , VanNasdale DA, Elsner AE, Weber A, Miura M, Haggerty BP : Determination of foveal location using scanning laser polarimetry.j Vis 9 : 21-17, Miura M, Elsner AE, Cheney MC, Usui M, Iwasaki T : Imaging polarimetry and retinal blood vessel quantification at the epiretinal membrane.j Opt Soc Am A Opt Image Sci Vis 24 : , Pircher M, Hitzenberger CK, Schmidt - Erfurth U : Polarization sensitive optical coherence tomography in the human eye.prog Retin Eye Res 30 : , Gotzinger E, Pircher M, Geitzenauer W, Ahlers C, Baumann B, Michels S, Schmidt - Erfurth U, Hitzenberger CK : Retinal pigment epithelium segmentation by polarization sensitive optical coherence tomography.opt Express 16 : , Makita S, Hong YJ, Miura M, Yasuno Y : Degree of polarization uniformity with high noise immunity using polarization - sensitive optical coherence tomography.opt Lett 39 : , Yamanari M, Miura M, Makita S, Yatagai T, Yasuno Y : Phase retardation measurement of retinal nerve fiber layer by polarization - sensitive spectral - domain optical coherence tomography and scanning laser polarimetry.j Biomed Opt 13 : , Sugiyama S, Hong YJ, Kasaragod D, Makita S, Uematsu S, Ikuno Y, Miura M, Yasuno Y: Birefringence imaging of posterior eye by multi - functional Jones matrix optical coherence tomography. Biomed Opt Express 6 : , Miura M, Yamanari M, Iwasaki T, Elsner AE, Makita S, Yatagai T, Yasuno Y : Imaging polarimetry in age - related macular degeneration.invest Ophthalmol Vis Sci 49 : , Miura M, Makita S, Sugiyama S, Hong YJ, Yasuno Y, Elsner AE, Tamiya S, Tsukahara R, Iwasaki T, Goto H : Evaluation of intraretinal migration of retinal pigment epithelial cells in age - related macular degeneration using polarimetric imaging.sci Rep 7 : 3150, Hong YJ, Miura M, Ju MJ, Makita S, Iwasaki T, Yasuno Y : Simultaneous investigation of vascular and retinal pigment epithelial pathologies of exudative macular diseases by multifunctional optical coherence tomography.invest Ophthalmol Vis Sci 55 : , Read RW, Holland GN, Rao NA, Tabbara KF, Ohno S, Arellanes - Garcia L, Pivetti - Pezzi P, Tessler HH, Usui M : Revised diagnostic criteria for Vogt - Koyanagi - Harada disease : report of an international committee on nomenclature.am J Ophthalmol 131 : , Miura M, Makita S, Yasuno Y, Tsukahara R, Usui Y, Rao NA, Ikuno Y, Uematsu S, Agawa T, Iwasaki T, et al : Polarization - Sensitive Optical Coherence Tomographic Documentation of Choroidal Melanin Loss in Chronic Vogt - Koyanagi - Harada Disease.Invest Ophthalmol Vis Sci 58 : , Zanzottera EC, Messinger JD, Ach T, Smith RT, Freund KB, Curcio CA : The Project MACULA Retinal Pigment Epithelium Grading System for Histology and Optical Coherence Tomography in Age - Related Macular Degeneration.Invest Ophthalmol Vis Sci 56 : ,

8 218 東京医科大学雑誌第 76 巻第 2 号 Research and development of diagnostic imaging system for macular disease Masahiro MIURA Department of Ophthalmology, Tokyo Medical University, Ibaraki Medical Center Abstracr In this review, I present a brief discussion on the research and development of diagnostic imaging systems for macular disease, including polarization - sensitive optical coherence tomography and the polarization - sensitive scanning laser ophthalmoscope. These novel imaging techniques have the potential to completely change ophthalmology in a clinical setting. Key words: polarization sensitive optical coherence tomography, polarization sensitive scanning laser ophthalmoscope, macular disease, birefringence, depolarization 8

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